The treatment of all of the above, except the first, in simple cases, where there is not much constitutional disarrangement, consists mainly in attention to the general principles of health, cleanliness, exercise, food, ventilation, and clothing. Occasional doses of mild saline aperients (Epsom salts, cream of tartar, or phosphate of soda, or of sulphur combined with cream of tartar) should be taken, and warm or tepid bathing, preferably in sea-water, or, if not convenient, rain water, frequently had recourse to. Stimulants of all kinds should be avoided, and the red meats, ripe fruits, and the antiscorbutic vegetables should form a considerable portion of the diet. Lemonade, made by squeezing the juice of a lemon into a half-pint tumbler full of water, and sweetening with a little sugar, should be frequently and liberally taken as one of the best beverages in such cases. To relieve the itching and irritation (except in the pustular, crusted, and vesicular varieties), brisk friction with a fleshbrush or a fleshglove may be employed. The parts should also be wetted with an appropriate lotion after each friction or bath, or the use of soap and water.
In all the scaly eruptions, iodide of potassium internally, and ioduretted or sulphuretted lotions or baths are invaluable. In many of them of a malignant or obstinate character, as Lepra Psoriasis, Lupus, etc., small doses of solution of arsenite of potassa (liquor arsenicalis; the dose, from 3 to 5 drops, gradually and cautiously increased to 7 to 9 drops, twice a day, after a meal) prove highly serviceable. In the forms of psoriasis popularly called baker's itch, grocer's itch, and washer-woman's itch, the application of ointment of nitrate of mercury, diluted with ten or twelve times its weight of lard, has been highly recommended. A course of sarsaparilla is also in most cases advantageous.
The small, hard, distinct pimples—“acne, or acne simplex” of medical writers—that occur on the forehead, and occasionally on the temples and chin, generally yield to stimulating lotions, consisting of equal parts of strong vinegar, or spirit, and water, or to weak lotions of sulphate of zinc, assisted by occasional doses of cooling laxatives, as the salines, or a mixture of sulphur or cream of tartar.
Freckles, or the round or oval-shaped yellowish or brownish-yellow spots, resembling stains, common on the face and the backs of the hands of persons with a fair and delicate skin who are much exposed to the direct rays of the sun in hot weather, are of little importance in themselves, and have nothing to do with the general health. Ladies who desire to remove them may have recourse to the frequent application of dilute spirit, or lemon juice, or a lotion formed by adding acetic, hydrochloric, nitric, or sulphuric acid, or liquor of potassa, to water, until it is just strong enough to slightly prick the tongue. One part of good Jamaica rum to two parts of lemon juice or weak vinegar is a good form of lotion for the purpose. The effect of all these lotions is increased by the addition of a little glycerine.
The preceding are also occasionally called “common freckles,” “summer freckles,” and “sun freckles.” In some cases they are very persistent, and resist all attempts to remove them while the exposure that produces them is continued. Their appearance may be prevented by the greater use of the veil, parasol or sunshade, or avoidance of exposure to the sun during the heat of the day.
Another variety, popularly known as cold freckles, occur at all seasons of the year, and usually depend on disordered health or some disturbance of the natural functions of the skin. Here the only external application that proves useful is the solution of bichloride of mercury and glycerine, or Gowland's lotion.
The Itch—“psora” and “scabies,” of medical authors; the “gale” of the French,—already referred to, in its common forms is an eruption of minute vesicles, generally containing animalcula (acari), and of which the principal seats are between the fingers, bend of the wrist, etc. It is, accompanied by intense itching of the parts affected, which is only aggravated by scratching. The usual treatment is with sulphur ointment (simple or compound) well rubbed in once or twice a day; a spoonful (more or less) of flowers of sulphur, mixed with treacle or milk, being taken at the same time, night and morning. Where the external use of sulphur is objectionable, on account of its smell, a sulphuretten bath or lotion, or one of chloride of lime, may be used instead. In all cases extreme cleanliness, with the free use of soap and water, must be strictly adhered to.
The small, soft discolorations and excrescences of the skin, popularly called moles, may be removed by touching them every second or third day with strong acetic or nitric acid, or with lunar caustic. If covered with hair they should be shaved first.
Extreme paleness of the skin, when not symptomatic of any primary disease, generally arises from debility, or from the languid circulation of the blood at the surface of the body; often, also, from insufficient or improper food, want of outdoor exercise, and the like. The main treatment is evident. Warm baths, friction, and stimulating lotions and cosmetics may be here employed, together with a course of some mild chalbeate (as the lactate, protophosphate, or ammonia-citrate of iron) and hypophosphate of soda.
Roughness and Coarseness of the skin, when not depending on any particular disease, may be removed or greatly lessened by daily friction with mild unguents or oil, or by moistening the parts, night and morning, with a weak solution of bichloride of mercury containing a little glycerine.